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Found 1,161 results
  1. Content Article
    In this BMJ Editorial, author Sam Patel says that linking medicines information from all care settings into a shared digital medication record accessible to all health and care clinicians has the potential to substantially reduce medication errors and improve patient safety. 
  2. Content Article
    The safety, effectiveness, and cost-effectiveness of molnupiravir, an oral antiviral medication for SARS-CoV-2, has not been established in vaccinated patients in the community at increased risk of morbidity and mortality from COVID-19. In this study, Butler et al. aimed to establish whether the addition of molnupiravir to usual care reduced hospital admissions and deaths associated with COVID-19 in this population. The authors conclude that molnupiravir did not reduce the frequency of COVID-19-associated hospitalisations or death among high-risk vaccinated adults in the community.
  3. Content Article
    Recording of the Health and Social Care Committee meeting held on Tuesday 13 December 2022. Meeting started at 10.03am, ended 11.45am.
  4. Content Article
    Regina Kamoga, Executive Director of the Community Health And Information Network (CHAIN) in Uganda, delivered this presentation to the 6th Annual Pharmacovigilance Stakeholder Meeting on 30 November 2022. The presentation outlines how CHAIN is working to develop and support expert patients and patient groups in underserved communities in Africa, as well as highlighting the key medication safety issues faced by these communities, including low health literacy, poor reporting culture and healthcare worker knowledge gaps. The presentation then looks at how CHAIN implemented the World Health Organization's (WHO) Global Patient Safety Challenge in Ugandan communities through patient engagement and healthcare worker education. To conclude the presentation, Regina makes recommendations to improve medication safety: Sustain advocacy for medication safety and become a voice to the voiceless Adopt a culture of safety that incorporates the patient as a care team member not a perceived receiver of care Build and strengthen networks on patient safety Communication and open discussion between healthcare providers and patients to improve patient doctor relationship Increase collaboration with civil society organisations and patient organisations Adopt Start Early In Life initiative to instil a safety culture early in life Establish medication safety multidisciplinary working group Patient, family and community engagement should be at the core of key stakeholders interventions
  5. Content Article
    Extravasation is the unintentional leakage of vesicant fluids or medications from the vein into the surrounding tissue. This can cause harm and lead to complications for the patient. This guide, produced by the Royal Children's Hospital Melbourne, includes: Introduction Aim Definition of terms Risk factors Assessment Management Irrigation Procedure Follow-up/Review Special considerations Evidence Table Companion documents References
  6. Content Article
    This policy paper, published by the Department of Health and Social Care, provides an update on the UK Government’s progress in implementing the recommendations of the Independent Medicines and Medical Devices Safety (IMMDS) Review, sometimes referred to as the Cumberlege Review.
  7. Content Article
    The BMJ, in partnership with the Choosing Wisely international collaboration, led by the Choosing Wisely Canada campaign, has introduced a “Change” series in the Education section. Articles in the series highlight evidence based strategies and tools to help change practice and reduce unnecessary tests, treatments, and procedures. The articles indicate why and how practice needs to change, usually focusing on one aspect of care, and are aligned with recommendations made by national Choosing Wisely campaigns.
  8. Content Article
    This investigation by the Healthcare Safety Investigation Branch (HSIB) explores the issues associated with the assessment of risk factors for venous thrombosis in pregnancy and the first six weeks after birth. Venous thrombosis occurs when a blood clot forms and causes a blockage in a person’s vein. This can lead to venous thromboembolism (VTE), when part of the clot breaks off and travels through the bloodstream, blocking a blood vessel elsewhere in the body. Pregnant women and pregnant people are at greater risk of developing a venous thrombosis than those who are of the same age and not pregnant. Because of the increased risk, healthcare staff assess a pregnant woman’s risk factors for VTE at key stages before and after the birth, so that they can be given preventative treatment if necessary. While rare, in the UK venous thrombosis and VTE is the leading direct cause of death of pregnant women during pregnancy or up to six weeks after the end of pregnancy. Reference event The reference event for this investigation was the case of Alice, who was 26 years old and was pregnant with her second child. A VTE risk assessment was completed for Alice at her first antenatal appointment, when she was admitted to hospital for the birth of her child, and 24 hours after admission. Her score was zero each time, meaning no risk factors were identified for VTE. During her pregnancy Alice reported experiencing some pain in her calf; she was examined by a doctor who referred her for a scan. This ruled out a deep vein thrombosis (DVT). After giving birth by caesarean section, Alice's risk assessment was repeated, and as it indicated that medication was required, a preventative dose of low-molecular-weight heparin was prescribed and Alice was discharged. Eleven days after the birth of her baby, Alice was taken by ambulance to the emergency department with chest pain, shortness of breath and leg cramps. She was diagnosed with a pulmonary embolism (PE) and was started on a treatment dose of blood-thinning injections. Following investigation, it was found that Alice may not have received an appropriate preventative dose of low-molecular-weight heparin to help prevent the VTE.
  9. Content Article
    Extravasation is the accidental leakage of any liquid from a vein into the surrounding tissues, which can cause serious harm to the patient (NHS England, 2017). From 1 April 2011 until 31 March 2021 the NHS paid £15.6 million in damages relating to extravasation. This leaflet, published by NHS Resolution, aims to share learning from those claims.
  10. Content Article
    Medication is the main part of the therapeutic process for hospital patients and with stocks of up to 200 medications held by hospital settings, it is estimated to be the second-highest spending chapter of health budgets. Management of medication stocks, their prescription and administration to patients (better known as the “medication management pathway”) is an onerous activity for hospitals and healthcare professionals. Tasks in this pathway are largely manual and non-digitalised. Visibility of medicine stocks is low; medication data is unfindable and low digitalisation of the pathway makes it highly prone for the occurrence of medication errors. Current rates of digitalisation combined with the high rates of manual activities undermines patients and healthcare professionals’ wellbeing and hospital systems resilience. For medication errors alone, the impact from the current low levels of digitalisation in hospitals costs the OECD group $54 billion and 3 million avoidable hospital days. With the advent of the European Medicine’s Agency new European Shortages Monitoring Platform (ESMP) which will manage medication shortages and the European Health Data space for cross border patient care, current levels of Digitalisation of Hospitals Medication management pathways will reduce the reliability and success of these new initiatives to respond effectively to future health care crises. It is therefore crucial that the European Union invests in the Digitalisation of Hospitals Medication management pathways for patient safety, healthcare professionals’ wellbeing and for hospital resilience.
  11. Content Article
    Patient safety is vital to well-functioning health systems. A key component is safe prescribing, particularly in primary care where most medications are prescribed. Previous research has demonstrated that the number of patients exposed to potentially hazardous prescribing can be reduced by interrogating the electronic health record (EHR) database of general practices and providing feedback to general practitioners (GPs) in a pharmacist-led intervention. This study aimed to develop and roll out an online dashboard application that delivers this audit and feedback intervention in a continuous fashion.
  12. Content Article
    This case study describes the project that won the 'Future-proofing Healthcare 2022' category in the Healthcare Quality Improvement Partnership's (HQIP's) Clinical Audit Heroes Awards. The Sustainable Respiratory Care Audit team at Newcastle Hospitals NHS Foundation Trust was recognised for its work improving care for individual patients while also reducing the environmental impacts of healthcare. Their nomination detailed how the project provided a structure for the audit of patients’ techniques, preferences and knowledge about inhalers, and the need for a clinical review—interventions that can reduce the carbon footprint of healthcare while improving the quality of care.
  13. Content Article
    Sarah Kay and Jaydee Swarbrick are involved in the Patient Safety in Primary Care Project in Dorset. In this blog, they summarise a recent event they held to share learning from medicines incidents.
  14. Content Article
    Medications and specifically fall-risk-increasing drugs (FRIDs) are associated with increased risk of falls: reducing their prescription may improve this risk. This study from Cox et al. explored patient characteristics associated with FRID use, prevalence and type of FRIDs and changes in their prescriptions among older people with arm fractures over 6 months. The study found that more than one FRID prescription had a significantly higher number of co-morbidities and medications and higher rates of male gender, polypharmacy, frailty and sarcopenia. The most frequently prescribed FRIDs were antihypertensives, opioids and antidepressants. Use of FRIDs among older people with upper limb fragility fractures was high. Although overall use decreased over time, 59% were still on 1 or more FRID at the 6-month follow-up, with trends to stop opioids and start antidepressants. Older people presenting with upper limb fractures should be offered a structured medication review to identify FRIDs for targeted deprescribing.
  15. Content Article
    This paper in the Journal of Patient Safety and Risk Management addresses the issue of untested products being used on the basis of 'equivalent' products having undergone regulatory testing. Manufacturers of competing products often use each other’s evidence, arguing that the published evidence is generally applicable even if the original tests and trials were performed on only one specific product. In this study, the authors looked at prophylactic dressings for pressure injury prevention to demonstrate how patient safety may be compromised if study conclusions are projected onto unstudied products.
  16. News Article
    Insulin rights activists and those who live with diabetes are calling for meaningful action to address the high costs of insulin in the United States as a new study shows the widespread habit of rationing the life-saving medicine. A study published on 18 October in the Annals of Internal Medicine by researchers at Harvard Medical School, the City University of New York’s Hunter College and Public Citizen, found that 1.3 million Americans rationed insulin due to the high costs of insulin in 2021. The staggering number represents an estimated 16.5% of the US population with diabetes. The study found insulin rationing was most commonly reported by those without health insurance coverage and individuals under the age of 65 not eligible for Medicare. Black insulin users were more likely to report rationing insulin, at 23.2%. The impact of the practice can be terrible. Janelle Lutgen of Dubuque county, Iowa, lost her 32-year-old son Jesse, a type 1 diabetic, after he started rationing his insulin because he lost his job and with it his health insurance and died in early 2018 from diabetic ketoacidosis. Without health insurance, Lutgen said over-the-counter insulin costs more than $1,000 (£865) a month, and that her son couldn’t afford the high cost of healthcare coverage in the marketplace without a job and wasn’t eligible for Medicaid coverage because his income from when he was working was too high. “It would probably be impossible to really know exactly all the harm that’s been done with high insulin prices,” said Lutgen, who explained that individuals who ration insulin because of the cost, if they do survive, can still experience other health impacts such as neuropathy, or losing toes or feet. “It seems like we can’t get it through legislators’ heads that we have to make sure everyone who needs insulin can get it, not just people who have insurance or people on Medicare – everybody. The only way to do that is to go to the root of the problem, big pharma.” Read full story Source: The Guardian, 1 November 2022
  17. News Article
    The Deputy President of the Medical and Health Workers Union of Nigeria, Kabiru Sani, has said that 50% of deaths recorded in the sector are caused by unsafe medication practices and medication errors. This is as he lamented that the health sector loses $42bn annually due to the wrong medications. He stated this at an event in commemoration of 2022 World Patient Safety Day, themed, “Medication Safety” held in Abuja. He said, “According to WHO, unsafe medication practices and medication errors are a leading cause of injury and avoidable harm in health care systems across the world. Globally, the cost associated with medication errors has been estimated at $42bn annually. “We, therefore, need to draw the domestic and global attention of all relevant authorities to the challenges facing patients, and healthcare workers and the urgent need to ameliorate them. The overall objective of world patient safety is to enhance and promote global understanding of patient safety, increase public engagement in the safety of healthcare workers, and promote global actions to enhance patient safety and reduce patient harm." Read full story Source: Punch, 20 September 2022
  18. News Article
    In order to avoid risk of having adverse drug reactions capable of prolonging the treatment period in the health facilities in Nigeria, experts have advocated the empowerment of patients to know the drugs being administered on them. The call was made when the Occupational Health and Safety Managers in Nigeria commemorated the Work Patient Safety Day with the National Orthopaedic Hospital Igbobi, NOHI, Speaking at the programme aimed to advocate patient safety to members of staff of the NOHI with the theme: Medication Safety with the slogan ‘MEDICATION WITHOUT HARM’, the Director of Nursing services, NOHI, Mrs Temidayo Rasaq-Oyetola, said where there is no medication safety, patient is at the risk of having adverse reaction that can prolong his or her treatment period. She said: “Patients have the right to know their drugs and seek for clarification when necessary. “Where there is no medication safety, patient is at risk of having adverse reaction that can prolong the treatment period. “Patient’s safety should be every stakeholder’s priority that will lead to delivery of efficient health care and best patient outcome. Also, every health institution should ensure medication safety with series of checks.” Read full story Source: Vanguard, 23 September 2022
  19. News Article
    Copperbelt province Clinical Care Specialist Morgan Mweene has warned people against buying medicines from undesignated places such as buses or on the street as the trend is risky to their health. And stakeholders on the Copperbelt have come together to advocate for reduced deaths or disability related cases resulting from wrong administering of medicine to patients in health facilities. Speaking at the inaugural World Patient Safety Day, commemorated in Ndola under the theme, “Medication Safety”, Dr Mweene emphasised the need for people to avoid buying medicines from undesignated places such as buses and on the streets. He further urged patients to take keen interest in medication given at hospitals. “As health workers, we also need to take interest in patients. As health workers let us not tire as we the custodian of health. It is our duty that we take keen interest of whatever we administer to our patients,” he said. Read full story Source: Mwebantu, 30 September 2022
  20. News Article
    Some batches of an antibiotic medicine called teicoplanin (brand name Targocid) are being urgently recalled in the UK because of possible contamination. The two affected batches are labelled 0J25D1 and 0J25D2, say safety experts. Patients and prescribers are being asked to check packs and stop using the medicine if it has either batch number. Four patients so far have suffered high fevers just hours after being given a dose from these batches. Other products containing teicoplanin are not affected by the recall. The Medicines and Healthcare products Regulatory Agency (MHRA) says the two batches of Targocid 200mg powder for making a solution to take as an injection, by infusion or by mouth, were found to contain high levels of bacterial endotoxins - a toxic compound found in bacterial cell walls that can cause inflammation-related symptoms, high fever and, in very serious cases, septic shock. Read full story Source: BBC News, 21 October 2022
  21. News Article
    Indonesia has temporarily banned all syrup-based and liquid cough medicines after the death of nearly 100 children from acute kidney failure since the start of this year. Most of those affected are said to be below the age of six. Muhammad Syahril Mansyur, the country’s health ministry spokesman, said: “Until today, we have received 206 reported cases from 20 provinces with 99 deaths.” He added: “As a precaution, the ministry has asked all health workers in health facilities not to prescribe liquid medicine or syrup temporarily … we also asked drug stores to temporarily stop non-prescription liquid medicine or syrup sales until the investigation is completed.” The ban, announced by the health ministry on Wednesday, applies to prescription and over-the-counter medicines. It comes after nearly 70 children died of acute kidney failure this year in the Gambia, linked to four brands of paracetamol cough syrup manufactured by India’s Maiden Pharmaceuticals. Read full story (paywalled) Source: The Times, 20 October 2022
  22. News Article
    An expert panel convened by the US Food and Drug Administration voted 14-1 on Wednesday to recommend withdrawing a preterm pregnancy treatment from the market, saying it does not work. During the sometimes contentious three days of hearings, the drugmaker Covis Pharma, backed by some clinicians and patient groups, had argued there is evidence to suggest the drug, called Makena, might work in a narrower population that includes Black women at high risk of giving birth too soon. But FDA experts and others said the data does not support such a view. In closing arguments, Peter Stein, director of the Office of New Drugs at the FDA’s Center for Drug Evaluation and Research, agreed on the urgent need for a drug to reduce the incidence of preterm birth — a leading cause of infant mortality in the United States. But he said the data indicates that Makena is not that drug. Stein said, “Hope is a reason to keep looking for options that are effective,” he said. “Hope is not a reason to take a drug that is not shown to be effective, or keep it on the market.” Read full story Source: The Washington Post, 19 October 2022
  23. News Article
    Shortages and rising costs of medicines could result in patients not receiving important prescriptions, community pharmacists have warned. Commonly prescribed drugs used to treat conditions such as osteoporosis, high blood pressure and mental health are among those affected. The Department of Health (DoH) said a support package worth £5.3m for the sector is being finalised. But Community Pharmacy NI said this "falls way short of what is needed". David McCrea from Dundela Pharmacy said the price of some medicines had been raised "fiftyfold". "As a community pharmacist for over 30 years, I have never witnessed the price of medicines rise this sharply," Mr McCrea said. "It is becoming increasingly hard for us to afford to buy the medicines from wholesalers because we are not being paid the full cost of these drugs by the department." Mr McCrea added the current situation was causing "financial stress" and was becoming unsustainable. "The bottom line is that we are now facing the situation where we will not be able to afford to supply our patients with essential medicines, within weeks." Read full story Source: BBC News, 18 October 2022
  24. News Article
    Doctors have criticised new health secretary Therese Coffey over reports that pharmacists will be allowed to prescribe antibiotics without the approval of a doctor. According to The Times, Ms Coffey’s “Plan for Patients” will give pharmacists the power to prescribe certain drugs, such as contraception, without a prescription in an effort to reduce the need for GP appointments and tackle waiting lists. Responding to reports of the plans, Rachel Clarke, an NHS palliative care doctor and writer, wrote on Twitter: “This is staggeringly irresponsible of Therese Coffey and will cause so much more harm than good. “Doctors do not – unlike Coffey – dish out spare antibiotics to our family and friends because we’re painfully aware of the harms of antibiotic resistance. Utter recklessness.” Stephen Baker, a professor at Cambridge University and an expert in molecular microbiology and antimicrobial resistance, branded the health secretary’s plans “moronic”. He told the newspaper that the more antibiotics were used “the more likely we are to get drug-resistant organisms”. He added that it was “nuts” to consider widening access to drugs, adding that resistance against antibiotics is “clearly one of the biggest problems humanity is facing in respect of infectious disease at the moment”. Read full story Source: The Independent, 17 October 2022
  25. News Article
    Time is running out for hundreds of thousands of vulnerable people who are facing another winter shielding from Covid, campaigners have said. They are calling on the government to buy a drug called Evusheld to provide some protection against the virus. The government says it is not clear how long that protection will last when up against the Omicron variant. But patients, charities and health experts argue the protection offered is better than nothing. There are around 500,000 people in the UK with suppressed immune systems. That means their bodies struggle to produce antibodies, so the existing vaccines offer them little or no protection, leaving them very vulnerable to Covid. Blanche Hampton has lupus, a condition where her immune system has turned against her. The drugs she takes to control the lupus also suppress her immune system, meaning her body has no defences against Covid. Blanche has been shielding for two and a half years, but she believes Evusheld offers a chance for at least some kind of existence outside of her small flat in Inverkip, west of Glasgow. "Evusheld would give me a layer of protection, that is better than nothing. Because that's what I have currently - nothing." And Blanche, like many people who find themselves in the same situation, says she feels abandoned. Read full story Source: BBC News, 17 October 2022
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